Active surveillance for intraosseous mandibular haemangioma. Case report and literature review

Abstract

-Introduction:Intraosseous mandibular haemangiomas are rare benign tumors.To this date there is no general consensus regarding their treatment. Observation: The authors present a case of a 56-year-old patient with swelling of the basilar left edge, without any other associated symptom. Radiolucent images with a well-defined honeycomb structure supports the vascular injury found using dental orthopantomography and cone beam computed tomography. Dynamic magnetic resonance angiography (MRA) showed mild intense intralesional vascularity and a biopsy confirmed the diagnosis of mandibular cavernous haemangioma. Clinical and radiological active surveillance were carried out. The size of the lesion had regressed by more than half in one year and there was no more palpable lump. Discussion: The most commonly approved treatment approach of haemangioma is selective embolization followed by complete surgical resection, which may be complicated by bleeding. From the follow-up of this case it seems that an active clinical and radiological surveillance can be proposed in the management of intraosseous mandibular haemangioma with few persistent symptoms and a low risk of complication, these may even regress with time.

Intraosseous Hemangioma with unusual presentation

“…Robson and many other studies showed female to be more predilicted than men with a ratio of almost 2. [ 11 12 13 14 15 ] But in this case, the patient was a 47-year-old male which was not in accordance with the study conducted by Smith et al . and Zlotorgoski and did not coincide with the studies mentioned in the literature.…”

“…When detected in mandible, the body of the mandible is the most common site to be affected. [ 15 17 ] Anna et al . and Moore et al .…”

“…But sometimes patients might report with discomfort and facial asymmetry because of the inflammation of the soft tissue. [ 15 ] Apart from this, other signs and symptoms like pain, paresthesia, vestibular obliteration, expansion of the buccal and lingual cortex, bluish discoloration along with oozing or pulsatile bleeding from the gingiva, deranged occlusion, mobile teeth, and hastened exfoliation of the primary teeth is also elicited. [ 12 21 22 ]…”